County-Level Association of Social Vulnerability with COVID-19 Cases and Deaths in the USA

Khazanchi, Rohan; Beiter, Evan R.; Gondi, Suhas; Beckman, Adam L.; Bilinski, Alyssa; Ganguli, Ishani

doi:10.1007/s11606-020-05882-3

Cited by 180 publications

(229 citation statements)

References 3 publications

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“…This aligns with prior research that found that in urban communities, factors such as unemployment, crowded housing, and vehicle access were associated with increased diagnosis of and mortality from COVID-19. 13 Interestingly, a greater proportion of essential workers was not associated with more COVID-19 cases after adjustment. In fact, it appeared to confer protection.…”

Section: Discussionmentioning

confidence: 90%

Association of race, ethnicity, and community-level factors with COVID-19 cases and deaths across U.S. counties

et al. 2021

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Section: Discussionmentioning

confidence: 90%

Association of race, ethnicity, and community-level factors with COVID-19 cases and deaths across U.S. counties

et al. 2021

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“…[ 36 ] Consistent with our results, that study found that housing value, housing density, and income were protective against infection, while crowded households were associated with increased risk. Other work has compiled aggregate indices of social vulnerability,[ 9 , 37 , 38 ] and found that cumulative levels of social vulnerability were associated with increased mortality. Our census-tract-level analysis provides additional specificity of which neighborhood characteristics may be driving that vulnerability.…”

Section: Discussionmentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) mortality and neighborhood characteristics in Chicago

Bryan

Sun

Jagai

et al. 2021

Annals of Epidemiology

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“…Recent studies have demonstrated the importance of considering social vulnerability in both COVID-19 cases and deaths, although the findings have been somewhat inconsistent [ 17 – 19 ]. Karaye et al examined associations between the SVI and cumulative COVID-19 cases on May 12, 2020 [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, the authors found no association when they examined six states with high testing rates. Khazanchi and colleagues conducted an analysis of COVID-19 cases and deaths through April 19, 2020, and found that those living in the most vulnerable counties (highest SVI) had greater risk of infection and death [ 19 ]. Nayak et al examined associations between the SVI and COVID-19 incidence and case fatalities through April 4, 2020, and found a significant association between social vulnerability and case fatality but not incident cases [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

Neelon

Mutiso

Mueller

et al. 2020

Preprint

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Background: Emerging evidence suggests that socially vulnerable communities are at higher risk for coronavirus disease 2019 (COVID-19) outbreaks in the United States. However, no prior studies have examined temporal trends and differential effects of social vulnerability on COVID-19 incidence and death rates. The purpose of this study was to examine temporal trends among counties with high and low social vulnerability and to quantify disparities in these trends over time. We hypothesized that highly vulnerable counties would have higher incidence and death rates compared to less vulnerable counties and that this disparity would widen as the pandemic progressed. Methods: We conducted a retrospective longitudinal analysis examining COVID-19 incidence and death rates from March 1 to August 31, 2020 for each county in the US. We obtained daily COVID-19 incident case and death data from USAFacts and the Johns Hopkins Center for Systems Science and Engineering. We classified counties using the Social Vulnerability Index (SVI), a percentile-based measure from the Centers for Disease Control and Prevention in which higher scores represent more vulnerability. Using a Bayesian hierarchical negative binomial model, we estimated daily risk ratios (RRs) comparing counties in the first (lower) and fourth (upper) SVI quartiles. We adjusted for percentage of the county designated as rural, percentage in poor or fair health, percentage of adult smokers, county average daily fine particulate matter (PM2.5), percentage of primary care physicians per 100,000 residents, and the proportion tested for COVID-19 in the state. Results: In unadjusted analyses, we found that for most of March 2020, counties in the upper SVI quartile had significantly fewer cases per 100,000 than lower SVI quartile counties. However, on March 30, we observed a crossover effect in which the RR became significantly greater than 1.00 (RR = 1.10, 95% PI: 1.03, 1.18), indicating that the most vulnerable counties had, on average, higher COVID-19 incidence rates compared to least vulnerable counties. Upper SVI quartile counties had higher death rates on average starting on March 30 (RR = 1.17, 95% PI: 1.01,1.36). The death rate RR achieved a maximum value on July 29 (RR = 3.22, 95% PI: 2.91, 3.58), indicating that most vulnerable counties had, on average, 3.22 times more deaths per million than the least vulnerable counties. However, by late August, the lower quartile started to catch up to the upper quartile. In adjusted models, the RRs were attenuated for both incidence cases and deaths, indicating that the adjustment variables partially explained the associations. We also found positive associations between COVID-19 cases and deaths and percentage of the county designated as rural, percentage of resident in fair or poor health, and average daily PM2.5. Conclusions: Results indicate that the impact of COVID-19 is not static but can migrate from less vulnerable counties to more vulnerable counties over time. This highlights the importance of protecting vulnerable populations as the pandemic unfolds.

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County-Level Association of Social Vulnerability with COVID-19 Cases and Deaths in the USA

Cited by 180 publications

References 3 publications

Association of race, ethnicity, and community-level factors with COVID-19 cases and deaths across U.S. counties

Association of race, ethnicity, and community-level factors with COVID-19 cases and deaths across U.S. counties

Coronavirus disease 2019 (COVID-19) mortality and neighborhood characteristics in Chicago

Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

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